Coronary heart disease (CHD) refers to plaque buildup in the arteries within the heart. Coronary artery disease (CAD) is an umbrella term for conditions, such as CHD, that affect the coronary arteries.
The terms “coronary heart disease (CHD)” and “coronary artery disease (CAD)” are often used interchangeably, and they can refer to the same condition. However, CAD can also refer to other vascular problems within the heart.
The symptoms of CAD and CHD are usually the same. And the hereditary and lifestyle factors that put you at risk for both conditions are also similar.
Treatment options for CHD are the same as those for a certain type of CAD, while other forms of CAD may need different approaches to manage or treat the problem.
This article takes a closer look at CHD and other types of CAD.
A diagnosis of CAD means you have a buildup of plaque in your coronary arteries. And that buildup is preventing your arteries from supplying the heart muscle with a steady and sufficient supply of oxygenated blood. The buildup of plaque is called atherosclerosis.
Too much plaque narrows the open passageway that carries blood through an artery. Plaque can also rupture, which then triggers the formation of a blood clot that can partially or completely block an artery.
Significant decreases in blood flow to the heart can cause chest pain known as angina. If blood flow diminishes too much or becomes blocked altogether by plaque buildup or a clot, the result is a heart attack and injury to heart tissue.
CHD is a type of CAD known as obstructive coronary artery disease. The other two main types of CAD are nonobstructive coronary artery disease and spontaneous coronary artery dissection (SCAD).
Obstructive coronary artery disease
Obstructive CAD refers to a condition in which plaque blocks or obstructs normal blood flow in one of the large arteries in the heart.
Nonobstructive coronary artery disease
Unlike obstructive CAD, nonobstructive CAD means the coronary arteries are narrowed, but not by plaque buildup. Causes of nonobstructive CAD include:
- coronary vasospasm (abnormal or ill-timed constriction of a coronary artery)
- endothelial dysfunction (problems with the inner lining of an artery)
- microvascular dysfunction (problems with the smaller arteries in the heart)
- myocardial bridging (pressure on the arteries from nearby heart muscle tissue)
Spontaneous coronary artery dissection (SCAD)
SCAD refers to a tear in a coronary artery that allows blood to leak into the layers of the artery wall, decreasing blood flow to the heart muscle.
You can have CHD without knowing it, though angina can be an early warning sign that your heart health needs a medical evaluation.
For many people, the first symptoms of CHD or nonobstructive CAD are those that accompany a heart attack, including:
- chest pain
- pain in the jaw, neck, shoulders, or arms
- shortness of breath
Chest pain and shortness of breath are medical emergencies
Sudden chest pain, even if it comes and goes, and shortness of breath should be considered medical emergencies. You or someone close to you should call 911, as successful heart attack treatment relies on prompt medical attention.
Atherosclerosis, the main cause of CHD, can take years to develop. About
People most at risk of CHD include those with:
- a family history of heart disease
- a sedentary lifestyle
- high blood pressure
- high cholesterol
Smoking and exposure to secondhand smoke account for about 30% of CHD mortality, according to a
A person’s sex may also play a role in their CAD risk. The
In mild cases, CHD may be treated with healthy lifestyle behaviors and medications to manage certain risk factors.
Heart-healthy lifestyle choices include:
- a diet rich in vegetables, fruits, whole grains, lean proteins, and little or no added sugars and processed foods
- adequate sleep (7–9 hours most nights)
- exercise all or most days of the week
- moderate, if any, alcohol consumption
- stress management
It’s also important to keep up with doctor appointments and, if necessary, take medications such as antihypertensives to manage blood pressure and statins to manage cholesterol.
For more severe cases, or in the event of a heart attack, treatments may include placing a stent in a blocked artery to improve blood flow (angioplasty) or attaching a blood vessel taken from elsewhere in the body to the heart to reroute blood flow around the site or coronary artery blockage (coronary artery bypass grafting).
You may hear CHD and CAD used to describe the same type of heart disease. In many cases, both descriptions are accurate. It may be easiest to think of CHD as a type of CAD, which is an umbrella term for any disease involving the arteries in the heart.
If you receive a diagnosis of some kind of heart disease, talk with your doctor about the best way forward to manage the condition and limit your risk of complications.
If a procedure such as surgery or stent placement is discussed, consider getting a second opinion and be sure you understand the risks and benefits of each procedure.